| Evergreen Behavioral Health, Llc | |
|
1431 Liberty St Se Salem OR 97302-4343 | |
| (503) 383-1613 | |
| Not Available |
| Full Name | Evergreen Behavioral Health, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1431 Liberty St Se, Salem, Oregon |
| Authorized Official Name and Position | Rachel Martin (OWNER) |
| Authorized Official Contact | 6125989227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Behavioral Health, Llc 1431 Liberty St Se Salem OR 97302-4343 Ph: (503) 383-1613 | Evergreen Behavioral Health, Llc 1431 Liberty St Se Salem OR 97302-4343 Ph: (503) 383-1613 |
| NPI Number | 1639879141 |
|---|---|
| Provider Enumeration Date | 03/06/2023 |
| Last Update Date | 03/06/2023 |
| Certification Date | 03/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639879141 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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